摘要
目的探讨毛细支气管炎患儿肺功能特点及吸入性布地奈德(普米克令舒)、丙酸氟替卡松(辅舒酮)治疗毛细支气管炎的疗效。方法毛细支气管炎患儿100例分为观察组、对照组。2组均采用综合治疗,观察组加用普米克令舒/辅舒酮吸入。测定治疗前、出院时、出院后3个月二组患儿潮气呼吸肺功能;观察其急性期症状缓解情况;回访出院后3个月及1a后健康情况。30例同龄健康儿童的肺功能为健康对照组。结果1.观察组在改善临床症状、减少住院天数上优于对照组(Pa<0.05)。2.观察组出院后3个月,咳嗽、气喘发作次数较对照组减少(Pa<0.05)。3.出院时观察组潮气量(TV/kg)的增加、呼吸频率(RR)的下降优于对照组(Pa<0.05);观察组25%潮气量时的潮气呼气流速(TEF25%)、达峰时间比(TPEF/TE)、达峰容积比(VPEF/VE)较入院时上升(Pa<0.05),3个月后恢复正常,与健康对照组比较无明显差异(P>0.05)。对照组出院时TEF25%、TPEF/TE、VPEF/VE与入院时无明显改变(Pa>0.05),3个月后仍未恢复正常。4.随访1a,观察组发展为支气管哮喘的几率低于对照组(P<0.05)。5.毛细支气管炎急性期临床评分与TPEF/TE、VPEF/VE呈负相关,临床评分数值越高,病情越重,TPEF/TE、VPEF/VE值越低。结论1.毛细支气管炎患儿用吸入性糖皮质激素早期干预治疗,对急性期症状的缓解、降低发展为支气管哮喘的几率有较好疗效。2.TPEF/TE及VPEF/VE可判断毛细支气管炎呼吸道阻塞严重程度。
Objective To explore the feature of lung function of children with bronchiolitis, and investigate the therapeutic effect of Budesonide（Pulmicort） and fluticasone propionate（ Flixotide）. Methods One hundred children with bronchiolitis were randomly divided into observe group and control group equally. The observe group treated with additional Pulmicort in hospital and utilize mist - container to inhalate Flixotide after discharged. The lung functions were determined before the therapy, post - therapy （discharge） ,3 months post - therapy. The symptomatic relieve of the acute stage.3 months after discharged and 1 year physical follow - up were observed. Thirty healthy even - aged children were taken as normal group. Results 1. Improving of clinical symptom and tmspitalization in inhalation group were significantly decurtated （ Pa 〈0. 05 ）. 2. After 3 months therapy,the frequence of cough and asthma outbreak in observe group was lower than that of control group（ Pa 〈 0. 05 ）. 3. Post - therapy （discharge） ： VT ascend, RR descended in inhalation group were more significantly than those of control group （ Pa 〈0. 05 ）, the TEF25% , VPEF/VE and TPEF/TE of inhalation group ascend（ Pa〈0. 05 ）. After 3 months therapy：No significant differences were found compared to the normal group（ P 〉 0. 05 ）. Post - therapy（ discharge ） ：No significant difference in TEF25%, VPTEF/VE and TPEF/TE of control group （Pa〉 0. 05 ）. After 3 months therapy ： The TEF25% , VPEF/VE and TPEF/TE of control group were different from those of normal group statistically. 4. After I year, the incidence of asthma of observe group was significantly lower than that of control group（ P 〈 0. 05 ）. 5. The clinical evaluation score of bronchiolitis in acute stage characterized negative cot＇relation to the TPEF/TE,VPEF/VE and TEF25 % which means the score higher, the condition more severe and the TPEF/TE,VPEF/VE and TEF25% lower. Condusions 1. In bronchiolitis children, early intervention treatment with inhalational glucocorticoid is effective not only to the symptomatic relieves in the acute stage but also to debase the odds of advancing to bronchus asthma. 2. TPEF/TE and VPEF/VE are correlation to the severity of bronchiolitis,an evaluate the bronchoilitis airway obstruction.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2007年第22期1703-1704,1756,共3页
Journal of Applied Clinical Pediatrics
